Yuwen Zhou, Meng Qiu

Cancer Center, Department of Thoracic West China Hospital

Objective: Both the combination of gemcitabine – cisplatin (GP) and paclitaxel-cisplatin (TP) have been recommended as the standard first-line treatments for patients with advanced non-small cell lung cancer (NSCLC) according to the guidelines of the National Comprehensive Cancer Network (NCCN). Several studies have shown that there is no statistically significant difference in efficacy between GP and TP. Thus, this study was aimed atevaluating the monetary costs for these two regimens in China from the economicpoint of view. Method: Based on the equal efficacy of both regimens, we conducted a cost-minimization analysis to compare GP and TP.A total of 115patients who were confirmed to be NSCL Catinoperable stage III or stage IV were reviewed, with 55 for the GP group and 60 for the TP group. All itemized expenses were classified into direct costs (chemotherapy, hospitalization,venous access, care fee and tests), adverse events-related costs, and indirect costs (travelling and work delay). The costs of supportive care were excluded.All the price of drugs in this study was reference to the domestic price andthe parts of Medicare reimbursement costs were not included. Result: The total direct costs of GP and TP for each patient per cycle were $1152.896.8 and $762.673.1(P=0.000), respectively. GP group spent $12.2 and $119.5 more than TP on adverse event-related costs and indirect costs. The total costs of GP and TP were $2241.0194. 0versus $1516.4146.5 for each patient per cycle, and the differences were statistically significant. The results indicate that TP is a more affordable option in China. Conclusion: A suitable regimen for individual patients should not only rely on efficacy and safety, the overall cost, including the economic burden on patients, should be taken into consideration. This study indicates that TP is more affordable option compared with GP as first-line treatment of patients with advanced non -small-cell lung cancer in China.

Key Words: Cost minimization  analysis  chemotherapy  NSCLC